In Wisconsin, Workers Compensation Benefits are Only Recoverable When an Employee Suffers an Injury

Workers Comp Claim WI

To recover workers’ compensation benefits in Wisconsin, a worker must have suffered an “injury.”  An injury can be either physical or mental harm caused by an accident.  An Accidental/Physical Injury causing harm is like when a trip or fall causes a broken bone.  An accidental injury can also aggravate or accelerate a pre-existing condition or ailment beyond its normal progression, such as an aging sore back that is worsened by heavy lifting.  Another type of injury is Occupational Disease which is physical or mental harm caused by occupational exposure.  Such is not sudden or traumatic or the result of a single incident.  An occupational disease is a process usually extending over a considerable period.  There can be a steady deterioration, swift or slow.  There can be improvements and relapse.  There can be recovery and reoccurrence.  For instance, a series of traumatic work-related back injuries can lead to an occupational disease.

So, to repeat, an accident can cause physical injury, described as either traumatic, occurring suddenly, or over some time.  

A Mental injury can result from a physical injury termed a Physical-Mental Injury.  A Mental injury can also occur due to some non-traumatic event occurring at work, termed a Mental-Mental Injury.  A mental injury can also aggravate a physical ailment or condition, termed a Mental-Physical Injury.

Confused?!  Don’t be…let’s back up and dissect the difference between an Accidental Injury and Occupational Disease.

An Accidental injury, occurring traumatically is recoverable if it is medically reasonable that the injury caused harm, such as a fall by a roofer from a ladder that resulted in a broken bone.  But what if the injury is not as dramatic as a fall?  Instead, the roofer hurts his back when he bends down to pick up a case of 75-pound shingles.  If the bending movement and weight is dramatic enough that it is medically probable that the motion aggravated the aging, low back beyond its normal progression or deterioration, then such injury will be recoverable for workers compensation benefits.  However, just a Wisconsin worker suffering an ache or pain at work is not enough to make it a recoverable injury. The ache or pain must be serious enough that it requires medical treatment.  Also, an injury that occurs at work must be related to the work, meaning a heart attack occurring at work where the worker was not under undue stress will be deemed nothing more than a coincidence for occurring at work and not recoverable for workers’ compensation benefits.

If you have suffered an accidental injury at work, you need to report it immediately to your supervisor, who is required to obtain the proper paperwork so that an Incident Report can be completed and given to the worker’s compensation insurance carrier.  Always get a copy of the Incident Report or take a picture of it on your phone.  Keep in mind that employers hate work injuries, and sometimes they like to ignore them or act like they never happened.  So, the injured worker must protect themself and help document the injury on their own too.  A good way to document a work injury is to:

  • Take pictures of the scene;
  • Take pictures of the body part involved if bruising, swelling or bleeding is evident;
  • Document the names and addresses of witnesses and try to commit them by a text or email message, getting them to discuss the injury and what they saw and did in response;
  • Try to record statements from co-workers and witnesses.  Get them talking and record their comments, observations, and responses on the voice app of your smartphone.  Keep in mind, that everybody is recording on their cell phones these days;
  • Have witness also complete Incident Reports and keep copies by taking a picture of it on your smartphone:
  • Keep a journal of the event. Answer the basic questions in detail Who (witnessed or came to your aid), What (a detailed description of what happened to you), Where (describe the area and conditions where the injury occurred), Why (try to recreate why the injury occurred), and When (date and time the injury occurred).

Seeking medical treatment as quickly as possible is another form of documenting the injury.  Make sure you describe to the medical staff that the injury occurred at work and how it happened in detail.

An injury that falls under Occupational Disease requires a process and cannot result from a single incident.  An example of an occupational disease is silicosis which can only be acquired as a result and an incident of working in an industry over an extended period.  When reporting a work injury as an occupational disease, it is sometimes difficult to determine the actual date of injury.  The first date of interrupted work with the employer whose employment caused the disability can be used, meaning that the first date of wage lost or the date that the employee steps away from his/her scheduled work duties to attend to the disease (i.e., a first medical appointment can be attributed as the date of the occupational disease).   When reporting an occupational disease to your employer and answering questions to the worker compensation insurance carrier, it is important to remember to include certain details in your description of the injury/disease:

  • Give a detailed and accurate description of the job duties performed;
  • Give specific descriptions of the duration, frequency, and repetitiveness of the specific offending job;
  • Try to locate an actual written job description that is true and accurate for the job you did;
  • Know the weight and height of items that you regularly push/pull/carry/lift;
  • Document your work environment/exposures with pictures, obtain the Material Safety Data Sheet (MSDS) for products that you are exposed to on the work site, and keep a journal of symptoms;
  • Seek specialized medical treatment for your symptoms;
  • Describe if your symptoms increase during employment or improve when off work.

Why are these details important?  An occupational disease is an injury resulting from the wear and tear of long-term employment activities, so such activity needs to be described to your medical providers to arm them with a strong basis of information upon which to rely on when supporting your injury as an occupational disease.  Judges want to know the intensity, frequency, and duration of the work you perform to determine if your condition is truly occupational.  Providing a written description of your work to your treating doctor to reference and have in your medical file gives credibility to your doctor’s opinion of work-relatedness because it shows that your doctor is fully aware of the job you performed.   Keep in mind that line supervisors will be called to testify at the hearing to minimize the activity of your job which caused your injury.  They will be coached to testify that their job was physically easy, that it did not involve repetitive movement, or that the lifting of weight was minimal.  So having a copy of the actual job description of your work is a great way to discredit such adverse witnesses.  If able, taking pictures of the specific details of your job, such as equipment, machinery, stations, sites, and conditions, will be helpful when telling your story, especially when describing it to your doctor and testifying at a hearing.

Still unsure what category of work injury you are suffering?  No worries, it’s complicated for sure.  Learn more when you call the Mays Law Office at (608)257-0440 for a free telephone consultation.  Attorney Lisa Pierobon Mays knows the right questions to ask and prides herself on representing Wisconsin injured workers.

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